Zara Cooper
speaker
200 appearances
1 recordings
1 series
first heard Sep 2017
last heard Sep 2017
Zara Cooper’s voice in public audio — every appearance, attributed to the second.
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Appearances
So, you know, patients who have rib fractures, cervical spine fractures, traumatic brain injury, um, you know, and and other internal organ injuries related to their falls will end up on the trauma service.
And the numbers of those patients are escalating rapidly.
Um, and so now you have trauma centers.
Like mine, where, you know, either almost fifty percent or even over fifty percent of the patients on the trauma service are, you know, geriatric and the vast majority of those are frail elders.
Yeah.
So in folks in places like Florida and Arizona, um, you know, you have centers where, you know, the majority of their patients are geriatric trauma.
Um, and those numbers are increasing.
And it's interesting because actually the biggest burden is not being borne by the trauma centers, it's by the non-trauma centers.
um and you know acute care hospitals.
Right, right.
So, you know, if if you take patients who are, you know, frail elders who either it's their first fall or they've had multiple falls, um, they have severe injuries that are then going to uh adversely affect their function, their quality of life, they're gonna have, you know, uh
acute and which will eventually turn into chronic pain or you know these were formerly independent people who are now going to be functionally dependent and need to live in nursing facilities, you know, those are major life changes.
And
Uh, for many of these patients that's exactly what they're facing after what we as trauma surgeons have learned are seemingly minor injuries, like you know, a few rib fractures or
um, you know, even a cervical spine fracture.
But in a frail elder, those are d devastating injuries.
And so, you know, the goal setting, the prognostication, you know, family meetings, and, you know, then we also have to think about end of life care and care planning, advanced care planning, um, and the end of life care that we provide in the hospital.
I will say that, you know, on average in hospital mortality for trauma patients is about five percent.
But for elderly patients it's twice that.
Um so typically we're dealing with older patients who um you know may have end of life issues that are actually related to their underlying health status, their frailty, multimorbidity, um, as opposed to just the injury um that they've recently sustained.
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